Kaiser Hearing Aid Benefit

I couldn’t even get Kaiser to do a timely hernia surgery, much less transfer a benefit out of network.

Off topic rant. Years ago I self-diagnosed an inguinal hernia around Labor Day, finally got to see a Kaiser surgeon the day after Thanksgiving who confirmed the diagnosis, and his office called me in the 2nd week in January to schedule the surgery. By then I’d already changed jobs, had new insurance, and had the surgery the Friday before Presidents Day. Six months of agony and a few weeks of recovery.

I hope I never have to have Kaiser as a provider again.

@joec said:

You used to be able to do that years ago, especially if you mentioned that you would be saving them money. I did that years ago when I bought my HA from costco and had Kaiser pay for it. But they stopped that. Only if you can’t get an appt and you complain loudly will they consider it. Usually, when you complain, you can mysteriously get an appt. sooner.

Thanks for the feedback, Joesc and the off-topic rant, Jay Man 2. FYI, Kaiser is asking me to use HearX West for my hearing aid benefit . HearX West’s (inflexible) prices are 43% higher than a local hearing aid center near my home that specializes in Phonak HA’s :mad:. With HearX West, for example, my out of pocket expense for the Phonak Audeo Yes V’s is $750 and the IX’s approximately twice that amount. In essence, they are diluting my HA benefit by forcing me to use HearX West :mad:. If Kaiser would allow me to transfer my HA benefit to the local hearing aid center near my home, I could get the IX’s with zero out of pocket expense plus a longer warranty. Through HearX West, my out of pocket expense for the IX’s would be $1,400-$1,500 for the pair :eek:.

Oh! This just in… Kaiser, according to an internet article a few years old, owns 50% of HearX West :eek:. So I ask you, what’s wrong with this picture?

PS- Please don’t get me wrong…I very much appreciate the HA benefit I have through my employer and do not want to sound ungrateful. And I realize some of us have no HA benefit at all and have to pay 100% of the cost of their HA’s…but I think Kaiser should either allow me to get the most out of my benefit by allowing me to transfer it to the hearing center of my choice or insist that HearX reduce its prices to a more competitive level. Otherwise my HA benefit is not as much as advertised…its $1500 less.

@joesc said:

Well, that’s the managed care model. You use their doctors and facilities for the lower premiums and they have to make it up somewhere. If you didn’t have the benefit at all, you’d be paying full price. Also, if you company offers a choice in plans, you can wait until your next enrollment period to see what the other plans offer or look at your old enrollment information, and how much more you would have to pay in premiums for the other plans.

At my company, the other plans had higher premiums of $200/month and higher deductables and co-pays. So you need to do an overall cost benefit analysis.

Thanks, Joesc. The other plan offered during open enrollment is an 80/20 plan, they pay 100% of the cost of the HA’s, and there is no increase in premiums. And, the hearing center by my home said they would absorb the 20%. Sounds like a win-win situation. But I don’t live alone. My wife doesn’t want to leave Kaiser, and the 20% we’d have to pay for non-hearing-related services, for the entire family, with our kid’s medical history, might not make it cost effective.

@tsmith4034 said:

I guess you should be happy you have ANY HA benefit. Most insurances do not cover (like mine).

I am happy I have any benefit, Tsmith4034. I think what bothers me the most is that (I think) they are misrepresenting the advertised benefit.

I used my hearing aid benefit with Kaiser about 10 years ago. At that time I had double Kaiser coverage and it covered $7000 for my hearing aids. At that time I chose the widex in ear. I had 3 years manufacturer warranty. I received excellent service. My second pair of hearing aids were purchased through an independent clinic. I had won $2500 toward hearing aids. I ended up getting phonak audeo about 5 years ago. I had 2 years of free batteries, cleanings, testing. I decided to go back to Kaiser for my 3rd pair. Mainly as a result of the independent office changed hand twice. My current sr advantage plus gives $700 allowance and I have a plan through ATT that reimburses me up to $4000. Just easier to file paperwork with Kaiser. I go for my fitting on 11/.25 will update you.

Just to clarify. Each Kaiser Region runs differently. Also there is a HUGE variety of plans within each region with coverage ranging from all inclusive to bare bones.